Peanut epicutaneous immunotherapy (EPIT) is an emerging treatment designed to increase tolerance to peanut allergens by delivering small, controlled doses of peanut protein through the skin using a patch. The Viaskin Peanut patch is the leading EPIT product in development and functions by targeting immune cells in the skin to desensitize the body gradually over time. This method is particularly appealing for young children due to its non-invasive nature and favorable safety profile compared to oral immunotherapy (OIT), which carries a higher risk of systemic allergic reactions and comes with restriction of activities such as exercise and holding doses with illness.
The EPITOPE trial, a Phase 3 randomized controlled study, evaluated the safety and efficacy of Viaskin Peanut in 362 children aged 1 to 3 years. After 12 months of daily patch application, 67% of children in the treatment group met the primary endpoint—tolerating significantly higher amounts of peanut protein—compared to 33.5% in the placebo group. Most side effects were mild and localized to the application site, with no serious systemic reactions attributed to the patch. These results suggest EPIT is both effective and well-tolerated in very young children, offering a valuable early intervention for peanut allergy.
Two further Phase 3 trials, the VITESSE efficacy study in 4-7 year olds and the COMFORT safety study in 1-3 year olds, will hopefully lead to FDA approval of this product in 2026.
https://www.nejm.org/doi/full/10.1056/NEJMoa2212895
